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Korean J Pediatr Gastroenterol Nutr. 2006 Mar;9(1):39-47. Korean.
Published online Mar 31, 2006.  https://doi.org/10.5223/kjpgn.2006.9.1.39
Copyright © 2006 The Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition
A Suggested New Clinical Classification for Pediatric Intussusception
Moon Ho Park, Su Min Shon, Byung Kyu Choe, Yeo Hyang Kim, Hee Jung Lee,* Won Joung Choi, Ae Suk Kim, and Jin Bok Hwang
Department of Pediatrics, Keimyung University School of Medicine, Korea.
*Department of Diagnostic Radiology, Keimyung University School of Medicine, Korea.
Hyosung Children's Hospital, Daegu, Korea.
Department of Pediatrics, Dongguk University College of Medicine, Gyeongju, Korea.
Abstract

PURPOSE

We proposed a new classification of pediatric intussusception based on clinical and radiologic findings.

METHODS

Data from 88 consecutive patients with intussusception were reviewed. We retrospectively analyzed six factors; patient age, sites of intussusception, symptoms, therapeutic methods, existence of enlarged mesenteric lymph nodes, and ultrasonographic (US) findings from clinical records.

RESULTS

1) There was one neonatal case (1.1%), the others (98.9%) were infants and children. 2) These 87 infant and child cases consisted of 14 cases (16.1%) of small bowel intussusception (SBI) and 73 cases (83.9%) of ileo-colic intussusception (ICI). Of the 14 SBI cases, 12 cases were symptomatic and 2 cases were asymptomatic. The symptomatic group comprised 8 transient cases (66.7%), 3 operative cases (25.0%), and 1 enema-reduction case (8.3%). Two asymptomatic cases were incidentally captured by computed tomography. Of the 73 ICI cases, 19 cases (26.0%) required operation, and 54 (74.0%) enema-reduction. 3) When transient SBI cases were compared with operated SBI cases, enema-reduced and operated ICI cases, the age (38.0±22.9 months) of transient SBI cases were significantly higher than those of the others (p=0.003). Mean mass size (20.8±2.7 mm) in transient SBI was significantly smaller than in the others (p=0.0001). 4) No correlation was found between the existence of enlarged mesenteric lymph nodes and therapeutic method or concomitant illness. 5) Most of the target types observed by US were in transient SBI cases, the remainder were in the enema-reduced ICI cases. In terms of the doughnuts type, all 8 cases (34.8%) with an external hypoechoic rim thickness of >8.9 mm were treated surgically.

CONCLUSION

Pediatric intussusception may be classified based on clinical and radiologic findings, which are likely to indicate appropriate therapies.

Keywords: Intussusception; Classification; Doughnuts type